The importance of effective delivery of education and health services requires little justification but across OECD countries and indeed within OECD countries, there exist significant gaps in access and quality of these services. Without action, shrinking and ageing populations in many rural communities are likely to see not only fewer hospital beds per head of population, higher rates of morbidity, different skill-levels of, and higher demands on, local teachers and medical staff, but also differences in enabling infrastructures such as transport networks and digital connectivity, among many others. Through its disproportionate impact on senior citizens and in the heightened role that digital tools have played in mitigating the impacts of social distancing and in ensuring service delivery, the COVID-19 pandemic has reinforced the need for action.

This report, through its compilation of good policy practices and innovations to deliver education and health care services to citizens living in different geographies, especially in remote rural places, responds to that call. The report highlights the decisive role geography plays in determining access to these services and, in turn, the need for a spatial lens in developing policies that address inequalities in their provision and access. The report provides guidance for governments seeking to design sustainable and equitable long-term strategies for service delivery, with a focus on two key areas: digital connectivity and governance.

This report, the first of a new sub-series of reports (Preparing Regions for Demographic Change) was carried out as part of the OECD’s Regional Development Policy Committee (RDPC) Programme of Work on OECD Rural Studies. The RDPC provides a unique forum for international exchange and debate on regional economies, policies and governance. It was discussed in the 24th meeting of the Working Party on Rural Policy and was approved by the RDPC [CFE/RDPC/RUR(2020)6/REV2] via written procedure on December 15 2020.

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